Ten patients with femoral head fractures were evaluated with conventional hip radiographs, computed axial tomography (CT), and pelvic oblique radiographs. The CT scan was used to determine the plane of the fracture within the femoral head. The patient was then positioned with the fracture line parallel to the radiographic beam, resulting in a pelvic oblique radiograph. Intraoperative findings were correlated with the preoperative diagnostic studies. The CT-directed pelvic oblique radiograph was found to be the most accurate determinant of the extent of fracture displacement and joint congruency, thereby facilitating the choice of appropriate fracture treatment. Most importantly, similar radiographs, reproducible from one examination to the next, could readily be obtained after operation, providing excellent information concerning the adequacy and maintenance of fracture reduction and the progression of fracture healing.